中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2010年
11期
984-988
,共5页
李文华%尹立雪%陆景%钟毓%李春梅%邓燕%左明良%李爽%余洋%王正阳%王珊%罗安果%孟庆国
李文華%尹立雪%陸景%鐘毓%李春梅%鄧燕%左明良%李爽%餘洋%王正暘%王珊%囉安果%孟慶國
리문화%윤립설%륙경%종육%리춘매%산연%좌명량%리상%여양%왕정양%왕산%라안과%맹경국
超声心动描记术,三维%心脏起博,人工%心室功能,左
超聲心動描記術,三維%心髒起博,人工%心室功能,左
초성심동묘기술,삼유%심장기박,인공%심실공능,좌
Echocardiography%three-dimensional%Cardiac pacing,artificial%Ventricular function,left
目的 观察比格犬心室起搏状态左心室心肌三维峰值位移,量化评价心室不同起搏状态心肌力学状态特征,为优化心室起搏方式提供力学依据.方法 10只健康比格犬开胸模型,随机进行右心室心尖起搏(RVA-P)、左心室侧壁起搏(LVL-P)、左心室心尖起搏(LVA-P),分别采集各种起搏状态一个完整心动周期的全容积实时灰阶图像.分析评价基础状态(BASE)及心室不同起搏状态左心室心肌三维峰值位移(3D-D)及其达峰时间(3D-DTC)和达峰时间标准差(3D-DTSD).结果 ①LVL-P和LVA-P状态与BASE和RVA-P状态比较左心室的3D-D均有减低趋势,LVL-P与BASE、RVA-P状态比较左心室中前壁、中前间隔、中下壁、中后壁、中侧壁的3D-D差异有统计学意义(P＜0.05);LVA-P与RVA-P状态比较左心室中前壁、中侧壁、中后壁的3D-D差异有统计学意义(P ＜0.05);LVL-P和LVA-P状态与BASE和RVA-P状态比较左心室心尖水平各节段的3D-D差异有统计学意义(P＜0.05).②LVL-P与BASE状态比较左心室底下壁、中下壁、尖下壁的3D-DTC差异有统计学意义(P＜0.05);RVA-P、LVA-P状态与BASE状态比较左心室中侧壁的3D-DTC差异有统计学意义(P＜005);心室不同起搏状态与BASE状态比较左心室3D-DTC均发生前移.③BASE与心室不同起搏状态比较左心窒3D-DTSD均无显著性差异,RVA-P和LVA-P状态比较左心室3D-DTSD差异有统计学意义(P＜0.05).结论 RVA-P状态能够维持左心室心肌运动有效性和同步性;LVL-P和LVB-P状态均减低了正常左心室心肌三维运动的同步性,同时降低了左心室心尖和乳头肌水平节段心肌运动的有效性.通过对BASE及心室不同起搏状态左心室心肌三维状态的力学超声评价,有助于深入揭示更为真实的心室不同起搏状态左心室心肌力学异常.
目的 觀察比格犬心室起搏狀態左心室心肌三維峰值位移,量化評價心室不同起搏狀態心肌力學狀態特徵,為優化心室起搏方式提供力學依據.方法 10隻健康比格犬開胸模型,隨機進行右心室心尖起搏(RVA-P)、左心室側壁起搏(LVL-P)、左心室心尖起搏(LVA-P),分彆採集各種起搏狀態一箇完整心動週期的全容積實時灰階圖像.分析評價基礎狀態(BASE)及心室不同起搏狀態左心室心肌三維峰值位移(3D-D)及其達峰時間(3D-DTC)和達峰時間標準差(3D-DTSD).結果 ①LVL-P和LVA-P狀態與BASE和RVA-P狀態比較左心室的3D-D均有減低趨勢,LVL-P與BASE、RVA-P狀態比較左心室中前壁、中前間隔、中下壁、中後壁、中側壁的3D-D差異有統計學意義(P＜0.05);LVA-P與RVA-P狀態比較左心室中前壁、中側壁、中後壁的3D-D差異有統計學意義(P ＜0.05);LVL-P和LVA-P狀態與BASE和RVA-P狀態比較左心室心尖水平各節段的3D-D差異有統計學意義(P＜0.05).②LVL-P與BASE狀態比較左心室底下壁、中下壁、尖下壁的3D-DTC差異有統計學意義(P＜0.05);RVA-P、LVA-P狀態與BASE狀態比較左心室中側壁的3D-DTC差異有統計學意義(P＜005);心室不同起搏狀態與BASE狀態比較左心室3D-DTC均髮生前移.③BASE與心室不同起搏狀態比較左心窒3D-DTSD均無顯著性差異,RVA-P和LVA-P狀態比較左心室3D-DTSD差異有統計學意義(P＜0.05).結論 RVA-P狀態能夠維持左心室心肌運動有效性和同步性;LVL-P和LVB-P狀態均減低瞭正常左心室心肌三維運動的同步性,同時降低瞭左心室心尖和乳頭肌水平節段心肌運動的有效性.通過對BASE及心室不同起搏狀態左心室心肌三維狀態的力學超聲評價,有助于深入揭示更為真實的心室不同起搏狀態左心室心肌力學異常.
목적 관찰비격견심실기박상태좌심실심기삼유봉치위이,양화평개심실불동기박상태심기역학상태특정,위우화심실기박방식제공역학의거.방법 10지건강비격견개흉모형,수궤진행우심실심첨기박(RVA-P)、좌심실측벽기박(LVL-P)、좌심실심첨기박(LVA-P),분별채집각충기박상태일개완정심동주기적전용적실시회계도상.분석평개기출상태(BASE)급심실불동기박상태좌심실심기삼유봉치위이(3D-D)급기체봉시간(3D-DTC)화체봉시간표준차(3D-DTSD).결과 ①LVL-P화LVA-P상태여BASE화RVA-P상태비교좌심실적3D-D균유감저추세,LVL-P여BASE、RVA-P상태비교좌심실중전벽、중전간격、중하벽、중후벽、중측벽적3D-D차이유통계학의의(P＜0.05);LVA-P여RVA-P상태비교좌심실중전벽、중측벽、중후벽적3D-D차이유통계학의의(P ＜0.05);LVL-P화LVA-P상태여BASE화RVA-P상태비교좌심실심첨수평각절단적3D-D차이유통계학의의(P＜0.05).②LVL-P여BASE상태비교좌심실저하벽、중하벽、첨하벽적3D-DTC차이유통계학의의(P＜0.05);RVA-P、LVA-P상태여BASE상태비교좌심실중측벽적3D-DTC차이유통계학의의(P＜005);심실불동기박상태여BASE상태비교좌심실3D-DTC균발생전이.③BASE여심실불동기박상태비교좌심질3D-DTSD균무현저성차이,RVA-P화LVA-P상태비교좌심실3D-DTSD차이유통계학의의(P＜0.05).결론 RVA-P상태능구유지좌심실심기운동유효성화동보성;LVL-P화LVB-P상태균감저료정상좌심실심기삼유운동적동보성,동시강저료좌심실심첨화유두기수평절단심기운동적유효성.통과대BASE급심실불동기박상태좌심실심기삼유상태적역학초성평개,유조우심입게시경위진실적심실불동기박상태좌심실심기역학이상.
Objective To evaluate the changes of left ventricular(LV) 3-dimension peak displacement (3D-D) during different cardiac pacing patterns. To provide a reliable mechanical data base for the optimization cardiac pacing. Methods Cardiac pacings in open-chest Beagle canine models( n = 10) were performed using three patterns[I, e. , right ventricular apical pacing (RVA-P), LV lateral pacing (LVL-P)and LV apical pacing(LVA-P)],3D full volumetric real-time imaging were acquired in a completed cardiac cycle. The 3D-D,3D-D peak time (3D-DTc) and the standard deviation of TC(3D-DTSD) were calculated and analyzed in different pacing patterns for difference and spatial correlationship. Results ① The 3D-D of LVL-P and LVA-P state decreased compared with BASE and RVA-P state, there were significant 3D-D difference of mid anterior,mid anteriorspetal, mid interior,mid posterior, mid lateral between LVL-P and BASE, RVA-P patterns( P ＜0.05). There were significant 3D-D difference of mid anterior,mid lateral,mid posterior between LVA-P and RVA-P patterns groups( P ＜0.05). There were significant 3D-D difference of all segments in apical level between LVL-P,LVA-P and BASE, RVA-P states( P ＜0.05). ② Corrected by the heart rate,the 3D-DTC of different cardiac pacing patterns were shorter than BASE state. ③ There were no significant 3D-DTSD difference between different cardiac pacings and BASE patterns. There were significant 3D-DTSD difference between RVA-P and LVA-P patterns (P ＜ 0.05). Conclusions LV mechanical activation and synchronization could be maintained during RVA-P rather than LVA-P and LVL-P. Echocardiographic study of left ventricular 3D-D can actually reveal myocardial mechanical state during different cardiac pacings and BASE patterns.
